背景与目的：急性胆囊炎（AC）是常见的外科急症。最近的证据表明，在急性感染的诊断和严重程度分层中，血清降钙素原（PCT）优于白细胞增多和血清C反应蛋白。本文就PCT在AC诊断中的作用作一综述。严重性分层，和管理。材料与方法：PubMed，Embase,和Scopus从开始到2022年8月21日检索报告PCT在AC中作用的研究。对现有文献进行了定性分析。结果：五篇文章，包括688名病人,包括在内。PCT≤0.52ng/mL具有区分1级和2-3级AC的公平辨别能力（曲线下面积（AUC）0.721，p<0.001），PCT>0.8ng/mL具有良好的区分3级和1-2级AC的能力（AUC0.813，p<0.001）。PCT截止值≥1.50ng/mL可预测腹腔镜胆囊切除术困难（敏感性91.3%，特异性76.8%）。PCT≥1ng/mL时，开放转化的发生率更高(32.4%vs.14.6%,p=0.013)。PCT值>0.09ng/mL可以预测主要并发症(定义为开放转换，机械通气,和死亡）。结论：小样本研究的异质性困扰着当前的证据。虽然PCT在评估严重程度和预测困难的胆囊切除术方面有一定的作用，以及AC患者的术后并发症，需要更多的证据来验证它的使用。
Background and Objectives: Acute cholecystitis (AC) is a common surgical emergency. Recent evidence suggests that serum procalcitonin (PCT) is superior to leukocytosis and serum C-reactive protein in the diagnosis and severity stratification of acute infections. This review evaluates the role of PCT in AC diagnosis, severity stratification, and management. Materials and Methods: PubMed, Embase, and Scopus were searched from inception till 21 August 2022 for studies reporting the role of PCT in AC. A qualitative analysis of the existing literature was conducted. Results: Five articles, including 688 patients, were included. PCT ≤ 0.52 ng/mL had fair discriminative ability (Area under the curve (AUC) 0.721, p < 0.001) to differentiate Grade 1 from Grade 2-3 AC, and PCT > 0.8 ng/mL had good discriminatory ability to differentiate Grade 3 from 1-2 AC (AUC 0.813, p < 0.001). PCT cut-off ≥ 1.50 ng/mL predicted difficult laparoscopic cholecystectomy (sensitivity 91.3%, specificity 76.8%). The incidence of open conversion was higher with PCT ≥ 1 ng/mL (32.4% vs. 14.6%, p = 0.013). A PCT value of >0.09 ng/mL could predict major complications (defined as open conversion, mechanical ventilation, and death). Conclusions: Current evidence is plagued by the heterogeneity of small sample studies. Though PCT has some role in assessing severity and predicting difficult cholecystectomy, and postoperative complications in AC patients, more evidence is necessary to validate its use.
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